Adult Dosing
Rheumatoid Arthritis, Osteoarthritis and Ankylosing Spondylitis
- Naprosyn TAB/SUSP: 250/375/500 mg PO bid
- EC-Naprosyn: 375-500 mg PO bid
- Anaprox: 275 mg PO bid
- Anaprox DS: 550 mg PO bid
- Naprelan: 750-1000 mg PO qd [Max:1500 mg]
- Aleve, Midol Extended Relief, Pamprin All Day: 220 mg PO bid-tid, may take first dose as 440 mg PO [Max: 660 mg/day]
Management of Pain, Primary Dysmenorrhea, and Acute Tendonitis and Bursitis
Anaprox/Anaprox DS
- Initial dose: 550 mg PO
- Followed by 550 mg PO bid or 275 mg PO tid-qid
- Max initial dose: 1375 mg then daily max dose: 1100 mg
Naprelan
- Initial dose 1000- 1500 mg PO, followed by 1000 mg PO daily
- Max daily dose 1000 mg
Aleve, Midol Extended Relief, Pamprin All Day
- Start 440 mg PO, then 220 mg PO bid-tid
- Max: 660 mg/day
Acute Gout
- Naprosyn: Starting dose 750 mg PO, followed by 250 mg PO tid until the attack subside
- Anaprox: Starting dose 825 mg PO, followed by 275 mg PO tid until the attack subside
- Naprelan: Starting dose 1000-1500 mg PO qd, followed by 1000 mg qd until the attack subside
Pediatric Dosing
Juvenile Arthritis (
12 yrs)
- Naprosyn suspension: 5 mg/kg PO bid
Juvenile Arthritis, Management of Pain, Primary Dysmenorrhea and Acute Tendonitis and Bursitis
Midol Extended Relief, Pamprin All Day
- Start 440 mg PO, then 220 mg PO bid-tid
- Max: 660 mg/day
Bursitis (Non-FDA Approved)
- Child >2 yrs: 5-7 mg/kg/dose PO q8-12 hrs
[Outline]
Naprosyn, Anaprox, Anapros DS, Naprelan, Aleve
- Relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile arthritis, tendonitis, bursitis, acute gout
- Management of pain
- Management of primary dysmenorrhea
EC-Naprosyn
- Relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile arthritis
Renal Dose Adjustment (Based on CrCl)
- CrCl < 30 mL/min: Avoid use
Hepatic Dose Adjustment
- Hepatic impairment: Caution advised, dose adjustments not defined
Geriatrics
- No more than 200mg Q12 for self medication of pain
- COX-2 selective and nonselective NSAIDs shown an increase risk of serious and potentially fatal cardiovascular thrombotic events, MI and stroke. Use lowest effective dose for patient treated with NSAID to minimize the potential risk for an adverse CV event [US Black Box Warning]
- Use with caution in hypertensive patient because NSAIDs can lead to new hypertension or worsening of pre-existing hypertension, which may contribute to increased incidence of CV events. Monitor BP closely before starting the therapy and throughout the course
- Fluid retention, edema and peripheral edema have been reported with NSAIDs. Use with caution in patient with fluid retention, hypertension, or heart failure
- Increase in risk of GI adverse events such as bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. It occurs mostly with concomitant use of oral corticosteroids or anticoagulants, longer duration of NSAID therapy, smoking, use of alcohol, older age, and poor general health status [US Black Box Warning]
- Patients and physicians should remain alert for signs and symptoms of GI ulceration and bleeding during therapy
- Renal papillary necrosis, renal insufficiency, acute renal failure, and other renal injury have been associated with long term use of NSAIDs. It is contraindicated in severe renal impairment
- Naproxen should not be administered to asthmatic patients who experience rhinitis with or without nasal polyps, or who exhibit severe, potentially fatal bronchospasm with aspirin or other NSAIDs
- Serious skin reactions like exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), can occur with naproxen. Discontinue the drug at the first sign of hypersensitivity
- Avoid use of drug at starting of 30 weeks of gestation it may cause premature closure of the ductus arteriosus
- Elevation ALT or AST or sometime severe hepatic reactions, including jaundice and fatal fulminant hepatitis, liver necrosis and hepatic failure have occurred during therapy
- Anemia may occur due to fluid retention, occult or gross GI blood loss, patients on long term naproxen therapy should have their hemoglobin or hematocrits regularly
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment
- History of gastrointestinal bleeding or ulceration
- Hypertension
- Fluid retention
- Heart failure
- Cardiovascular disease
- Risk of cardiovascular diseases
- Congestive heart failure
- Peptic Ulcer Disease
- Pre-existing asthma
- Coagulation disorder
- Concomitant anticoagulant use
- Concomitant diuretic use
- Concomitant corticosteroid use
- Alcohol use
- Smokers
- Elderly patients
- Dehydration
Pregnancy Category:C
Breastfeeding: Limited information shows that low level of naproxen is secreted in breastmilk and adverse event in breastfed infants are apparently uncommon. Alternate drug may be preferred while nursing a newborn or preterm infant as naproxen have long half life and serious adverse reaction in a breastfed neonate are reported, This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 13 January 2011). As per manufacturer data due to the possible adverse effects of prostaglandin-inhibiting drugs on neonates, use in nursing mothers should be avoided.
US Trade Name(s)
- Aleve
- Anaprox
- Anaprox DS
- EC-Naprosyn
- Midol Extended Relief
- Naprelan
- Naprosyn
- Pamprin All Day
US Availability
naproxen (generic)
- TABS: 250, 375, 500 mg
- ORAL SUSP: 25 mg/mL
- ETABS: 375, 500 mg
naproxen sodium (generic)
- TABS: 250, 500 mg
- OTC CAPS: 200 mg
- OTC TABS: 200 mg
Aleve (naproxen sodium)
- OTC TABS: 220 mg
- OTC CAPLET: 220 mg
Anaprox (naproxen sodium)
Anaprox DS (naproxen sodium)
EC Naprosyn (naproxen)
- Delayed Release TABS: 375, 500 mg
Naprosyn (naproxen)
- TABS: 250, 375, 500 mg
- SUSP: 125 mg/5 mL
Naprelan (naproxen sodium)
Midol Extended Relief, Pamprin All Day
Canadian Trade Name(s)
- Aleve
- Anaprox
- Naprelan
- Naprosyn
- Nu-Naprox
Canadian Availability
naproxen (generic)
- TABS: 125, 250, 375, 500 mg
- ETABS: 750 mg
naproxen sodium (generic)
Aleve (naproxen sodium)
Anaprox (naproxen sodium)
Naprelan (naproxen sodium)
Naprosyn (naproxen)
- TABS: 250, 375, 500 mg
- ETABS: 750 mg
- SUSP: 25 mg/mL
Nu-Naprox (naproxen)
- TABS: 125, 250, 375, 500 mg
UK Trade Name(s)
- Naprosyn
- Naproxen
- Synflex
- Feminax Ultra
UK Availability
naproxen (generic)
- TABS: 250 mg, 500 mg
- ETABS: 250 mg, 375, 500 mg
Feminax ultra (naproxen)
Naprosyn (naproxen)
- TABS: 250 mg, 500 mg
- ETABS: 250 mg, 375, 500 mg
Synflex (naproxen sodium)
Australian Trade Name(s)
- Aleve
- Anaprox
- Femme-free
- Inza
- Naprosyn
- Proxen SR
- Crysanal
- Chemist's own period pain tablet
- Eazydays Tablets
- Naprofem
- Naprogesic
- Nurolasts
Australian Availability
Aleve (naproxen sodium)
Anaprox (naproxen sodium)
Femme-free
Inza (naproxen)
Naprosyn (naproxen)
- TABS: 250, 500 mg
- ORAL SUSP: 25mg/mL
- ETABS: 750, 1000 mg
Proxen SR (naproxen)
Crysanal
Chemist's own period pain tablet, Eazydays Tablets, Naprofem, Naprogesic, Nurolasts (naproxen sodium)
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Anaprox DS 550 MG TABS [Bottle] (GENENTECH)
30 mg = $117.99
90 mg = $328.97 - EC-Naprosyn 375 MG TBEC [Bottle] (GENENTECH)
30 mg = $57.99
90 mg = $165.97 - Naproxen 500 MG TABS [Bottle] (GLENMARK PHARMACEUTICALS)
60 mg = $19.99
180 mg = $47.97 - Naprosyn 125 MG/5ML SUSP [Bottle] (GENENTECH)
300 5ml = $54.33
900 5ml = $145.34 - Naprosyn 375 MG TABS [Bottle] (GENENTECH)
100 mg = $180.71
300 mg = $506.76 - Naprelan 375 MG TB24 [Bottle] (SHIONOGI PHARMA)
30 mg = $278.77
90 mg = $729.7 - Naproxen 375 MG TABS [Bottle] (GLENMARK PHARMACEUTICALS)
90 mg = $18.99
180 mg = $24.98 - Aleve 220 MG TABS [Bottle] (BAYER CONSUMER)
100 mg = $24.93
300 mg = $52.13 - Naproxen Sodium 550 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
30 mg = $14.99
90 mg = $25.99 - Naprelan 750 MG TB24 [Bottle] (SHIONOGI PHARMA)
30 mg = $250
90 mg = $709.94 - Naprelan 500 MG TB24 [Bottle] (SHIONOGI PHARMA)
30 mg = $270
90 mg = $740 - EC-Naprosyn 500 MG TBEC [Bottle] (GENENTECH)
30 mg = $74.99
90 mg = $205.96 - Naproxen 125 MG/5ML SUSP [Bottle] (ROXANE)
500 5ml = $51.49
1500 5ml = $119.45 - Anaprox 275 MG TABS [Bottle] (GENENTECH)
30 mg = $75.99
90 mg = $215.97 - Naproxen 250 MG TABS [Bottle] (GLENMARK PHARMACEUTICALS)
90 mg = $15.99
180 mg = $20.97 - Naprosyn 500 MG TABS [Bottle] (GENENTECH)
30 mg = $76.99
90 mg = $214.81
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
